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Subsequent to dental extraction, residual ridge resorption manifests as an inherent biological process unfolding over an approximate duration of one year. This intrinsic phenomenon entails a substantial diminution, occasionally reaching 50%, in the initial bucco-lingual dimensions of the mandibular bone. To address this issue, a dental procedure known as the two-stage ridge split intervention is employed. This process involves two distinct stages: ridge splitting and extension. In the first stage, the dentist splits the alveolar crest to create a widening gap. This allows for the subsequent placement of dental implants. The splitting process is carefully executed to ensure that there's enough space for the implants to be securely embedded, and in the second stage, the widened gap generated through the split and extension of the alveolar crest is replenished with a suitable material. Two common options are hydroxyapatite, a synthetic bone-like substance that promotes bone regeneration, or autogenous bone grafts, which are harvested from the patient's bone, often from another site within the mouth. Following this two-stage procedure, the next step is to place dental implants. However, there's typically a waiting period of eight to 12 weeks. This interval allows for proper healing and integration of the grafted or filled material with the existing bone before the implants are installed. In this case report, a specific patient's experience with the two-stage ridge split procedure in the mandibular region is mentioned. Such case studies are valuable in assessing the success and viability of this dental intervention in narrow mandibular-width cases.
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Background Total treatment time in implant placement can be significantly reduced by placing immediate implants into the freshly extracted sockets. Also, immediate implant placement can act as a guide for proper and accurate implant placement. Additionally, in immediate implant placement, the resorption of bone associated with the healing of the extraction socket is also reduced. This clinical study aimed to clinically and radiographically assess the healing of endosseous implants having different surface characteristics in nongrafted and grafted bone. Methodology In 68 subjects, 198 implants were placed, including 102 oxidized (TiUnite, Göteborg, Sweden) and 96 turned surface implants (Nobel Biocare Mark III, Göteborg) were placed. Survival was considered with clinical stability and acceptable function with no discomfort and no radiographic or clinical signs of pathology/infection. Rest cases that showed no healing and implant no osseointegration were considered failures. Clinical and radiographic examination was done by two experts after two years of loading based on bleeding on probing (BOP) mesially and distally, radiographic marginal bone levels, and probing depth (mesial and distal). Results Five implants failed in total where four implants were with the turned surface (Nobel Biocare Mark III) and one was from the oxidized surface (TiUnite). The one oxidized implant was in a 62-year-old female and was placed in the region of mandibular premolar (44) of length 13 mm and was lost within five months of placement before functional loading. Mean probing depth had a nonsignificant difference between oxidized and turned surfaces with the mean values of 1.6 ± 1.2 and 1.5 ± 1.0 mm, respectively, with P = 0.5984; mean BOP in oxidized and turned surfaces was 0.3 ± 0.7 and 0.4 ± 0.6, respectively (P = 0.3727). Marginal bone levels, respectively, were 2.0 ± 0.8 and 1.8 ± 0.7 mm (P = 0.1231). In marginal bone levels related to implant loading, a nonsignificant difference was seen in early loading and one-stage loading with P-values of 0.06 and 0.09, respectively. However, in two-stage placement, significantly higher values were seen for oxidized surfaces (2.4 ± 0.8 mm) compared to turned surfaces (1.9 ± 0.8 mm), with P = 0.0004. Conclusions This study concludes that nonsignificantly higher survival rates are associated with oxidized surfaces compared to turned surfaces after two years of follow-up. Higher marginal bone levels were seen in oxidized surfaces for single implants and implants placed in two stages.
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Background To achieve a better long-term prognosis in the posterior maxilla with poor quality of bone, the sinus lift must ensure bone regeneration till the apex of the dental implant for osseointegration. An indirect sinus lift is a minimally invasive procedure where simultaneous bone condensation is achieved. During the sinus lift procedures, different graft materials are used to gain the height of the bone in the sinus. The present study aimed to evaluate the outcomes of indirect sinus lift with hydraulic pressure and the simultaneous placement of implant using platelet-rich fibrin (PRF). Methodology In total, 24 subjects aged 18-74 years with missing maxillary premolars and first and second molars who opted for dental implants placed with indirect sinus lift with hydraulic pressure and had low sinus with less residual ridge height, bone density, and bone height were assessed at one day, one week, one month, three months, and six months. Results The average mean height preoperatively was 5.573 ± 0.66 mm which showed a significant increase postoperatively to 9.603 ± 0.78 mm (p < 0.001). Mean sinus membrane lift was 4.8 ± 2.2 mm at six months. The implant stability quotient increased significantly at six months postoperatively from 69.07 ± 3.39 at the immediate postoperative time to 72.92 ± 2.714 at six months postoperatively (p < 0.001). Conclusions The current study suggests that minimally invasive indirect sinus lift with bone augmentation utilizing PRF increased residual alveolar ridge height and implant stability with fewer problems than previous sinus lift procedures in the posterior maxillary area.
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AIMS: The present study was conducted for analyzing age and gender-related alterations in gingival width (GW) in patients of known population. MATERIALS AND METHODS: Two hundred and ten healthy participants were enrolled in the present research. All the participants were divided into the following study groups with seventy participants in each group based on their age: adolescents, young adults, and older adults. All the participants were recalled and oral and periodontal examination was carried out using mouth mirror, probe, and explorer. Lidocaine spray was used for anesthetizing the anterior gingival region. A probe was used for assessing the width of the gingiva, in which and rubber stopper was fitted. In all the six maxillary anterior and mandibular anterior teeth, the width and thickness of the attached gingivae were assessed. All the measurements were recorded and analyzed. RESULTS: Mean width of the attached gingiva in the maxillary arch in adolescents, young adults, and older adults were found to be 2.51 mm, 2.93 mm, and 3.92 mm, respectively. Mean width of the attached gingiva in the mandibular arch in adolescents, young adults, and older adults were found to be 1.76 mm, 2.39 mm, and 3.19 mm, respectively. Significant results were observed while comparing the GW among participants divided on the basis of age group. Nonsignificant results were observed while comparing the GW among participants divided on the basis of gender. CONCLUSION: There is a significant enhancement of GW with the advancement of age in both the maxillary arch and mandibular arch.
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AIM: The present study was undertaken for assessing the C-reactive proteins (CRP) levels and IL-6 levels in patients with peri-implantitis. MATERIALS AND METHODS: A total of 20 patients with confirmed clinical and radiographic diagnosis of peri-implantitis were included in the present study. Another set of 20 subjects who reported for routine health check-up were included as healthy controls. All the subjects were recalled in the morning and fasting (minimum of 12 h) venous blood samples were obtained. Plain vials were used for collecting the venous blood which was sent to the laboratory for biochemical analysis. In the laboratory, levels of CRP were assessed by means of latex enhanced nephelometric method, and interleukin 6 (IL-6) was assessed by means of Elisa kit. RESULTS: Mean levels of CRPs in patients of the peri-implantitis group and the control group was found to be 0.795 mg/dL and 0.294 mg/dL respectively. Mean IL-6 levels among the patients of the peri-implantitis group and the control group was found to be 12.178 pg/ml and 6.458 pg/ml respectively. While analyzing statistically, significant results were obtained. CONCLUSION: Enhanced periodontal inflammation in peri-implantitis patients is accompanied by a considerable increase in the concentration of CRPs and IL-6.
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BACKGROUND: Bone grafting aims at better dental implant osseointegration and preserves the remaining alveolar bone in the socket. The success of various bone grafting materials plays a vital role in assessing future implant function. AIMS AND OBJECTIVES: The present clinical trial was aimed at evaluating the results of guided bone regeneration (GBR) with and without the bioresorbable membrane in the dental implant placement. MATERIALS AND METHODS: The 20 patients were divided into two groups (n = 10). First was Group I- GBR with bioresorbable collagen membrane (BioGide™) and second was Group II- GBR without membrane. Bone gain and bone levels were analyzed for both groups. All the collected data were analyzed statistically. RESULTS: For Group I, bone levels at baseline were nonsignificant (P = 0.2188) Similarly, nonsignificant values were seen in both groups at 3 months with bone level values of 0.25 ± 0.17 and 0.38 ± 0.24 for Group I and Group II, respectively. Changes in the bone levels were found to be 2.45 ± 0.349 and 2.58 ± 0.304 from Group I and II, respectively, inferring the nonsignificant difference with P value of 0.3723. The percentage of bone gain for intergroup at the end of 3 months was 89.15% ±0.678 for Group I and 88.68% ± 0.503%; these values were statistically nonsignificant (P = 0.982). CONCLUSION: Nonsignificant difference was observed between the two groups with and without membrane in terms of changes in bone level, percentage of bone gain, and bone defect reduction. This study concludes that the use of bone grafts significantly improves residual alveolar ridge irrespective of membrane used.